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Sleep Apnea Sleep apnea can also cause serious changes in the cardiovascular system. Daytime hypertension (high blood pressure) is common.[1] Sleep Apnea is a progressive condition (gets worse as you age) and should not be taken lightly. [2] Sleep apnea is a disorder characterized by a reduction or cessation (pause of breathing, airflow) during sleep. It is common among adults but rare among children.[3] Sleep apnea actually may be underdiagnosed in women, particularly older women. In general, older women have the same incidence of sleep apnea as men their own age.[4] Sleep Apnea involves a condition in which a person stops breathing over and over again throughout the night, in many cases, for long periods of time. The side effects of this condition can be fatal.[5] Sleep apnea means "cessation of breath.".It is characterized by repetitive episodes of upper airway obstruction that occur during sleep, usually associated with a reduction in blood oxygen saturation. In other words, the airway becomes obstructed at several possible sites.[6] Sleep apnea is a period of time during which breathing stops or is markedly reduced. In simplified terms, a sleep apnea occurs when a person stops breathing for 10 seconds or more.[7] Sleep apnea is the most commonly diagnosed condition amongst sleep-related breathing disorders and can lead to debilitating and sometimes fatal consequences for the 18 million Americans who have been diagnosed with the disorder. This study identifies a mechanism behind stroke in these patients.[8] Sleep apnea can also occur if you have large tonsils or adenoids or a large uvula . During the day, when you are awake and standing up, these may not cause problems.[9] Sleep apnea affects many people. It is a condition where a person stops breathing while sleeping.[10] Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body ( sequelae ). Symptoms may be present for years (or even decades) without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.[11] Sleep apnea is a common disorder in which breathing stops during sleep for 10 seconds or more, sometimes more than 300 times a night. The hallmark of the disorder is excessive daytime sleepiness and compromised quality of life, including significant social and emotional problems.[12] Sleep apnea can also contribute to car accidents. [13] Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children.[14] Sleep apnea may also be characterized by choking sensations. The frequent interruptions of deep, restorative sleep often lead to early morning headaches and excessive daytime sleepiness.[15] Sleep apnea can cause serious problems if it isn't treated. Your risk of heart disease and stroke is higher if serious sleep apnea goes untreated.[16] Sleep apnea is responsible for job impairment and motor vehicle crashes because of the fatigue and drowsiness that contributes to poor judgment. [17] Sleep apnea can cause symptoms of apparent clinical depression which may respond quickly to treatment of the sleep disorder. A knowledge of the intellectual and emotional impact of sleep apnea may be important in making a correct differential diagnosis.[18] Sleep apnea is a serious, potentially life-threatening condition that should not be ignored and self-treatment is not recommended. [19] Sleep apnea is more common in people with atrial fibrillation (irregular heartbeat) than in patients with other heart conditions. In a 2005 study published in Circulation , 49% of patients with atrial fibrillation were at risk for developing apnea, compared with 32% of general cardiology patients.[20] Sleep apnea is a disorder in which a person stops breathing during the night, perhaps hundreds of times, usually for periods of 10 seconds or longer and sometimes for as long as a minute. These gaps in breathing are called apneas .[21] Sleep apnea also appears to put individuals at risk for stroke and transient ischemic attacks (TIAs, also known as “mini-strokes”), and is associated with coronary heart disease, heart failure, irregular heartbeat, heart attack, and high blood pressure. Although there is no cure for sleep apnea, recent studies show that successful treatment can reduce the risk of heart and blood pressure problems.[22] Sleep apnea may result in sudden infant death syndrome, or SIDS. [23] Sleep apnea caused by the incorrect positioning of the jaw may be treated with a device inserted into the mouth or strapped around the head to adjust the jaw’s positioning. Dental devices worn inside the mouth to treat sleep apnea look like athletic mouth guards.[24] Sleep apnea is now known to be a public health hazard because of accidents due to sleepiness. Moreover, patients often have hypoxemia with each apneic event, and profound and repetitive hypoxia can affect end organ systems.[25] Individuals with OSA syndrome have pathologic degrees of obstructive apnea, obstructive hypopnea, or both. Severity is quantified using a polysomnographic-derived index known as the apnea-hypopnea index (AHI).[28] Individuals vary normally in their need for, and their satisfaction with, sleep. Insomnia may cause problems during the day, such as tiredness, a lack of energy, difficulty concentrating, and irritability.[29]
CPAP is the best treatment for sleep apnea, but many patients find it uncomfortable and have trouble sticking to the therapy. As an alternative, some patients with mild-to-moderate sleep apnea use mouth guards or tongue splints.[30] CPAP -- which stands for continuous positive airway pressure -- is an effective treatment for sleep apnea. A mask is worn over the nose during sleep while compressed air is gently forced through the nose to keep the airway open.[31] CPAP is the gold standard treatment for sleep apnea. We have prepared an in depth article about Sleep Apnea which covers the history, types and treatment options relating to the disease.[32] CPAP treatment is used in most patients who have obstructive sleep apnea. With CPAP, the patient wears a snugly fitting nasal mask attached to a fan that blows air into the nostrils to keep the airway open during sleep ( Figure 9 ).[33] CPAP is more effective than oral appliances, but oral appliances may be easier for you to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.[34] CPAP is effective on 95% of the patient with obstructive sleep apnea. The units are reliable, quiet and efficient and come in a variety of sizes and shapes.[35] CPAP is effective on 95% of the patient with OSA. The pressure acts much in the same way as a splint, holding the airway open.[36]
Obstructive sleep apnea is not a benign disease. Bonekat (1990) estimated that in 1990 alone, 58,000 motor vehicle accidents involved a sleep apnea patient.[37] Obstructive sleep apnea affects more than 20 million Americans and can lead to hypertension , heart attack, stroke, depression, muscle pain, fibromyalgia , morning headaches, and excessive daytime sleepiness. Most people with mild sleep apnea are aware that they snore and feel overtired or fatigued but are unaware of potentially serious medical problems which may exist.[38] Obstructive sleep apnea affects 2 percent of children and has made headlines in recent years because it's more common in obese youth. Still, experts say, it's often overlooked by doctors.[39] Obstructive sleep apnea primarily strikes overweight men. Female hormones and a different throat anatomy may protect women until menopause.[40] Obstructive sleep apnea can be a complex condition. The Pillar Procedure can be an effective first step in your journey to a better night's sleep.[41] Obstructive sleep apnea causes your body to stop breathing during sleep. It occurs when the tissue in the back of the throat collapses and blocks the airway.[42] Obstructive sleep apnea poses a threat to your life and has been clinically identified to produce morbid consequences to your body such as obesity, hypertension, heart attack, stroke, diabetes, depression, dementia and unexplained sudden death. Science has dramatically proven that life ceases to exist within four days without water and two weeks without sleep.[43]
Central apnea occurs when the part of the brain that controls breathing doesn't start or properly maintain the breathing process. In very premature infants, it's seen fairly commonly because the respiratory center in the brain is immature.[45] Central sleep apnea usually occurs in people who are seriously ill. For example, it can occur in people with a variety of severe and life-threatening lower brain stem lesions.[46] Central sleep apnea is caused by a problem with the nerves that control breathing. In some cases a mixture of both types of sleep apnea may occur.[47] Central sleep apnea (CSA), less common than OSA, is a central nervous system disorder that occurs when the brain signal telling the body to breathe is delayed. CSA can be caused by disease or injury involving the brainstem, such as a stroke, a brain tumor, a viral brain infection, or a chronic respiratory disease.[48]
Oxygen administration may safely benefit certain patients but does not eliminate sleep apnea or prevent daytime sleepiness. Thus, the role of oxygen in the treatment of sleep apnea is controversial, and it is difficult to predict which patients will respond well.[51] Oxygen is a controversial treatment and it doesn't eliminate sleep apnea or daytime sleepiness and in not used to treat patients with obstructive sleep apnea. [52]
Tonsils and adenoids may grow to be large relative to the size of a child's airway (passages through the nose and mouth to the windpipe and lungs). Inflamed and infected glands may grow to be larger than normal, thus causing more blockage.[53] Tonsil and adenoid removal is frequently performed to treat chronic tonsillitis and recurring infection. But obstructive sleep apnea (OSA) is now the most common reason children have tonsil and adenoid surgery.[54]
Nasal obstruction, a large tongue , a narrow airway and certain shapes of the palate and jaw seem also to increase the risk. A large neck or collar size is strongly associated with obstructive sleep apnea.[55] Nasal pillows ("Adam circuit" is another name for the same thing) refers to a different method of delivering air with a CPAP machine. Basically, these are nose plugs that you use in place of a traditional mask over your nose (you still connect it to the hose to CPAP machine, like a mask).[56]
Children are much more likely to have their tonsils and adenoids removed to solve the problem. [58] Children born with other medical conditions, such as Down syndrome, cerebral palsy, or craniofacial (skull and face) abnormalities, are at higher risk for sleep apnea. Children with these conditions may need additional treatments.[59] Children who have sleep apnea nearly always snore. But they may not appear to be excessively sleepy during the day (a key symptom in adults).[60]
Patients biased toward more time supine during the initial polysomnography; no trends in time supine for in-home studies were noted. [62] Patients may also have episodes of hypopnea, when breathing doesn’t stop, but airflow is greatly reduced. SLEEP APNEA is diagnosed when a patient experiences 5 to 15 documented episodes of apnea-hypopnea/hour.[63]
Standing from a squatting position lowers blood pressure as can be experienced during normal daily activity. They also monitored the participants as they slept.[67] Standing from a squatting position lowers blood pressure as can be experienced during normal daily activity. They also monitored the participants as they slept.[68] |
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